Letters from Maine

Protective Custody


 

On my first pass through the February 2012 issue of Pediatrics, one title caught my eye. Societal Values and Policies May Curtail Preschool Children’s Physical Activity in Child Care Centers (Pediatrics 2012;129:265-74) screams out the obvious, but its message is one that this country needs to hear and take to heart. One could shorten the title to Societal Values and Policies Curtail Children’s Physical Activity and be correct.

Anyone who has spent any time with young children (or animals for that matter) must notice that given ample space and a variety of objects, the little creatures will stay active until they drop from temporary exhaustion. And, we don’t need two nutritionists and a statistician to remind us that inactivity is one of the key contributors to obesity.

© Orchidpoet/iStockphoto

Kids used to embark on grand, and potentially unsafe, adventures. Might safety concerns be contributing to inactivity and childhood obesity?

While Copeland and her coauthors list financial restraints and an emphasis on academics as major contributors to inactivity, it is safety concerns that earn their first star. In their study, day care providers were understandably worried about what might happen if a child was injured while they were in charge. This concern is unfortunately magnified by the litigious nature of our society. But parents also were concerned that their children would be injured during physical activity. Of course, none of us want our children to suffer any harm, but it seems to me that over the last 50 years, this instinctual concern has suffered a tragic metamorphosis and resulted in a paralysis that is eroding the health of our young people and, by extension, the entire population.

In the 1950s, when I was 12 years old, my parents allowed me and a friend to bicycle unaccompanied nearly 200 miles from Pleasantville, N.Y., to Cooperstown. We had no interest in the National Baseball Hall of Fame and Museum, just adventure. I think they underestimated our resolve and figured we would be back home by evening of the first day. But, they let it happen. Today, with cell phones and a GPS, that trip would probably be a much safer excursion. But can you imagine it happening?

Ironically, it is the communication explosion that could be making things safer for children, and it is one of the primary drivers of the protectionist mentality of today’s parents. Every abduction and gory accident becomes national and international news in a matter of seconds. The more gruesome and unusual, the faster it can go viral.

It has always seemed to me that just about everything good or bad can be described by a bell-shaped curve. Of course, horrible accidents and abductions occur in the tail of that curve – they are rare and anomalous. But because parents can hear about them and see them every day on a variety of media, they believe these terrible events are much more likely than they are. The result is that the tail is wagging the dog.

If you want to read how absurd the situation can become, you might want to check out some of the examples cited by Lenore Skenazy, who writes about them on freerangekids.wordpress.com. One school department chose to eliminate voting in school buildings because voters might present a danger to the schoolchildren.

As pediatricians, we can play a role in stemming the tide of unhealthy protective custody by helping parents understand the true frequency of bad events and by balancing our safety messages with a plea to give children time and space to use and explore with their bodies. I fear that sometimes we are overzealous in our safety messages while neglecting the important truths about the value of activity. Exploring with a parent the factors that are preventing his or her child from being active can be time consuming. But it is time well spent. Of course bad stuff will happen if we encourage vigorous play, but restricting it is creating a much worse outcome.

Dr. William Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at pdnews@elsevier.com.

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